Risk of Residual Neoplasia after a Local-Risk Resection of Colorectal Lesions by Endoscopic Submucosal Dissection: A Multinational Study

• Type: Article in International Scientific Journal
• Date: 2023

Authors

João Santos-Antunes (Author) FMUP; Pioche, M (Author) Other; Ramos Zabala, F (Author) Other; Cecinato, P (Author) Other; Gallego, F (Author) Other; Barreiro, P (Author) Other; Mascarenhas, A (Author) Other; Sferrazza, S (Author) Other; Berr, F (Author) Other; Wagner, A (Author) Other; Lemmers, A (Author) Other; Ferreira, MF (Author) Other; Albeniz, E (Author) Other; Uchima, H (Author) Other; Kuttner Magalhaes, R (Author) Other; Fernandes, C (Author) Other; Morais, R (Author) Other; Gupta, S (Author) Other; Martinho Dias, D (Author) Other; Faria Ramos, I (Author) Other; Marques, M (Author) Other; Bourke, MJ (Author) Other; Macedo G (Author) FMUP

Journal

Title: Journal of Clinical Medicine

Vol. 36

Final page: 5356

ISSN: 2077-0383

Publisher: MDPI

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 2 Citations

Other information

Authenticus ID: P-00Y-Z34

DOI: 10.3390/jcm12165356

Abstract (EN): Endoscopic submucosal dissection (ESD) in colorectal lesions is demanding, and a significant rate of non-curative procedures is expected. We aimed to assess the rate of residual lesion after a piecemeal ESD resection, or after an en bloc resection but with positive horizontal margins (local-risk resection-LocRR), for colorectal benign neoplasia. A retrospective multicenter analysis of consecutive colorectal ESDs was performed. Patients with LocRR ESDs for the treatment of benign colorectal lesions with at least one follow-up endoscopy were included. A cohort of en bloc resected lesions, with negative margins, was used as the control. A total of 2255 colorectal ESDs were reviewed; 352 of the ESDs were non-curative. Among them, 209 were LocRR: 133 high-grade dysplasia and 76 low-grade dysplasia. Ten cases were excluded due to missing data. A total of 146 consecutive curative resections were retrieved for comparison. Compared to the curative group, LocRRs were observed in lengthier procedures, with larger lesions, and in non-granular LSTs. Recurrence was higher in the LocRR group (16/199, 8% vs. 1/146, 0.7%; p = 0.002). However, statistical significance was lost when considering only en bloc resections with positive horizontal margins (p = 0.068). In conclusion, a higher rate of residual lesion was found after a piecemeal ESD resection, but not after an en bloc resection with positive horizontal margins.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9